title: ICU personnel have inaccurate perceptions of their patients' experiences.
abstract: BACKGROUND
  Intensive care unit (ICU) patient care bases - among others - upon the staff's assumptions about each patient's subjective preferences and experiences. However, these assumptions may be skewed and thus result in client-professional gaps (cp-gaps), which occur in two subtypes, hyperattention and blind spots to certain burdens. cp-gaps typically reduce quality of care. We investigated whether cp-gaps of either subtype exist in a 36-bed ICU of a university hospital.
  
  
  METHODS
  Observational study on 82 consecutive patients of a 36-bed university ICU, who voluntarily answered a psychometric questionnaire focusing on patients' experiences during an ICU stay. The questionnaire was reliable and valid (Cronbach's alpha, factor analysis). It consisted of 31 Likert-scaled items, which represented three scales of perception (communicative, intrapersonal, somatic) supplemented by 55 binary items for more specific information. Details of the questionnaire are given in the text. Demographic, educational, and medical data were registered too. Patients reported their subjective ICU experience 2-7 days after ICU discharge. Analogously, 60 staff members (physicians and nurses) reported their assumptions about patients' experiences. After correction for a general bias, group differences indicated cp-gaps.
  
  
  RESULTS
  Twelve cp-gaps were found. Hyperattention was found in four communicative and three intrapersonal items. Blind spots appeared in two communicative, two intrapersonal, and one somatic item. The pattern of cp-gap subtypes (hyperattention/blind spots) goes well with self-attributional bias - a model of social interaction.
  
  
  CONCLUSIONS
  cp-gaps in ICUs can be identified using analogue questionnaires for patients and staff. Both subtypes of cp-gap occur. cp-gaps are substantially influenced by self-attributional bias.
authors.affiliation: Department of Intensive Care Medicine and Intermediate Care, University Hospital Aachen, Aachen, Germany.
authors.forename: A W
authors.initials: AW
authors.lastname: Schindler
authors.forename: N
authors.initials: N
authors.lastname: Schindler
authors.forename: F
authors.initials: F
authors.lastname: Enz
authors.forename: A
authors.initials: A
authors.lastname: Lueck
authors.forename: T
authors.initials: T
authors.lastname: Olderog
authors.forename: D A
authors.initials: DA
authors.lastname: Vagts
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D003142:Communication; D003422:Critical Care / Q000523:psychology*; D003627:Data Interpretation, Statistical; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007398:Interpersonal Relations; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009726:Nurses; D010361:Patients / Q000523:psychology*; D010564:Personnel, Hospital / Q000523:psychology*; D010820:Physicians; D011184:Postoperative Period; D018401:Sample Size; D012938:Social Perception; D011795:Surveys and Questionnaires; D055815:Young Adult